05-4163 (PAT)P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00004163 Owner:
Property Address: 60590 LACE LEAF CT Larry Crosby
APN: 764-270-999-118 -300231- 60590 LACE LEAF CT
Application description: PATIO COVER - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 8579
!� Contractor:
Applicant: Architect or Engineer: D /p� a PELLETIER CONSTRUCTION
[nom 74691 SWEET WELL ROAD*
� THOUSAND PALMS, CA 92276
SEP '1 6 2
(760)275-7593
Lic. No.: Q�o9j 8
CITYof LA QjUI
- --_.. V,cme
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the eines5'2flrf-Rfofessionals Code, and my License is in full force and effect.
License Class: B -C33 / Lel a No.: 260484
Date:Odiute-Contra or:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of peri at I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter; improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , BAP.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/16/05
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
' Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 5495
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as ecome subject to the workers' compensation laws of California,
and agree that, if I s become ubject to the r s' compensation provisions of Section
3700 of the Labor, ode, I shall fo ith c y with ose provisions. ,
Date: Cd 10Applicant:
WARNING: FAILURE TO SECURE CRIERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN AL
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
certify that I have read this application and state that the ab ' formation is correct. I agree to comply with all
city and county ordinances and state laws relating to ' ing const ru ion, and h thorize.representatives
of this county to enter upon the above-mentioned operty for inspecti n purpo s.
�"
Date: � l(p d „Signature (Applicant or Ag tl: � -
Application Number. . . . . . 05-00004163
Permit . . . PATIO COVER
PERMIT
Additional desc .
Permit Fee . . . . 108.00
Plan Check
Fee
70.20
f" Issue Date . . . .
Valuation
. . .
. 8579
Expiration Date .. 3/15/06
"t Qty Unit Charge Per
Extension
BASE
FEE
45.00
7.00 9.0000 THOU BLDG
2,001-25,000
63.00
----------------------------------------------------------------------------
Special Notes and Comments
645 SF ALUMAWOOD LATTICE PATIO COVER.
HOA APPROVAL RECEIVED
----------------------------------'------------------------------------------
Other Fees . . . . . . . . STRONG MOTION (SMI)
- RES
.85
Fee summary Charged
Paid Credited
Due
-------------------------------------
Permit Fee Total 108.00
----------
.00
----------
.00
108".00
Plan Check Total 70.20
.00
.00
70.20
Other Fee Total .85
.00
.00
.85
Grand Total 179.05
.00
.00
179.05
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Aug 29 05 04:46p Patricia Hagan 760 771-9669 p.1
TMLOGYATLA QUINTA.
!MAINTENANCE ASSOCIATION
August 24, 2005
Larry & Marlene Crosby
6090 Lace Leaf Court
La Quinta, CA 92253
Property Address: 60590 Lace Leaf Court
Dear Mr. & Mrs. Crosby:
We are pleased to inform you that your application for patio cover, received on August 22, 2005, has been
conditionally approved by the Design Review Committee per the attached Conditions of Approval form.
'This approval does not constitute consent by the Association for the applicant to encroach, trespass, or build on
any property other than that of the applicant. This approval is related solely to the items reserved for anproval by
the CC&R's in accordance with the Architectural Guidelines. The approval does not extend to the quality of work
done by your architect, or contractor, or to any structural engineering, soils engineering, or site grading and drainage
design. You are urged to obtain the services of a stag licensed professional for consultation as needed.
Please be advised that this approval does not relieve you from obtaining any necessary building permits from the
governmental agencies involved. It is strongly recommended that you hold your final payment to any contractor
doing work on the exterior of your home until such time that a Design Review Committee member has inspected
your property and your deposit has been refunded to you. If any damage has been caused by your contractor to
common area property, the Association will have the necessary repairs made and deduct the cost from your deposit.
Therefore, it is important for you to wait for the deposit refund before you pay your contractor in full.
Sincerely, '
For the Desigr: Review Committee
Melinda Gutierrez, CCAM
Association Business Manager
Enclosures
cc: Board.of Directors
- Design Review Committee
Professionally ,Managed By Action Property Management, Inc.
60-750 Trilogy Parkwav, La Quittor, C.4 92253
(760) 777-6059 (760) 777-6097 fax
mguliemaz @actionlife. can
1ViVw. act ionlffe. coil!